The World Health Organization is urging countries to regulate e-cigarettes, nicotine pouches, and heated tobacco as strictly as traditional cigarettes — even suggesting outright bans. If implemented, those recommendations could deter millions of smokers from switching to lower-risk options, likely causing more smoking-related disease and death instead of preventing it.

In a new position paper, “WHO Position on Tobacco Control and Harm Reduction,” Director-General Dr. Tedros Adhanom Ghebreyesus asserts that e-cigarettes do not advance harm reduction by helping smokers move to safer nicotine sources. Instead, he argues, they are fueling a fresh wave of addiction among young people.

The WHO recommends that smokers use quitlines and nicotine replacement therapies rather than switching to e-cigarettes or nicotine pouches. But both approaches have low success rates and are often unavailable or unaffordable in low- and middle-income countries (LMICs), where most of the world’s smokers live. Many LMICs lack the public-health infrastructure of places like the United Kingdom or New Zealand, which have independently embraced certain nicotine alternatives as part of harm-reduction strategies. Those countries frequently rely on international bodies like the WHO for guidance, heightening the responsibility of such organizations to provide balanced, evidence-based advice.

The WHO has previously supported strict policies against e-cigarettes. In 2019 it praised India — a country with more than 250 million tobacco users and about one million tobacco-related deaths per year — for banning e-cigarettes. In 2024 it honored Brazil’s National Health Surveillance Agency for reaffirming a ban. E-cigarettes are also prohibited in Argentina, Thailand, Vietnam, and Mexico, nations that together account for more than 70 million tobacco users. Meanwhile, traditional cigarettes, the most harmful form of nicotine use, remain legal in all of these countries.

The WHO paper does not present evidence showing e-cigarettes or nicotine pouches are as harmful as smoking. The claim that vaping is safer than smoking is not merely an industry talking point: some of the WHO’s largest funders — including the United States, the United Kingdom, and Canada — officially recognize that e-cigarettes pose lower risks than combustible cigarettes. Their leading health agencies (the U.S. Food and Drug Administration, the U.K.’s Office for Health Improvement and Disparities, and Health Canada) all concur on that point. The Cochrane Review, the gold standard in evidence-based medicine, consistently finds e-cigarettes more effective than nicotine replacement therapy for helping people stop smoking.

Public-health bodies in the UK actively promote e-cigarettes to smokers. The National Health Service and Cancer Research UK routinely debunk claims that vaping is equal to or more dangerous than smoking. The NHS even offers some smokers free vape kits through its “swap to stop” initiative.

These policies appear to be working. Smoking rates in the UK have fallen significantly since vaping became widespread, and in November 2025 the number of vapers in the UK reportedly surpassed the number of smokers for the first time. The availability of e-cigarettes, nicotine pouches, and heated tobacco products has provided tens of millions of smokers — many who failed to quit through other means — with a viable alternative. Sweden, where many nicotine users choose snus (a non-combustible oral product), has the lowest smoking and lung-cancer rates in Europe.

A broad body of research also shows that the kinds of restrictions Dr. Tedros proposes — such as higher taxes or bans on flavors that consumers prefer — tend to drive people back to smoking traditional cigarettes. That outcome does not improve public health.

Yet despite evidence that vaping is markedly safer than smoking, the WHO continues to urge that, short of outright bans, these products should face the same taxes and regulations as cigarettes. It should be basic regulatory logic that products with very different risk profiles are treated differently. If the WHO’s recommendations are widely adopted, equating vapes, nicotine pouches, and similar alternatives with cigarettes will likely prolong and increase death and disease among smokers who want to quit but lack access to less risky options.

This article was adapted from an original report published on reason.org. All rights belong to the original publisher.